早期乳腺癌患者术后应用整形技术的临床观察  

Analysis of effects of therapies on breast cancer with plastic surgery

作　　者：杨庄青[1] 邹天宁[1] 陈德滇[1] 刘德权[1] 张季[1] 

机构地区：[1]昆明医学院第三附属医院云南省肿瘤医院乳腺科,云南昆明650118

出　　处：《中国美容医学》2012年第7期1095-1098,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察并总结采用整形美容技术对早期乳腺癌患者进行手术治疗的临床经验。方法:回顾性分析2007年3月～2011年2月期间我院收治的86例术前分期为I～II期的乳腺癌患者,分别应用腹直肌肌皮瓣(TRAM)、腹壁下动脉穿支皮瓣(DIEP)、TRAM与DIEP联合皮瓣、背阔肌肌皮瓣(LDF)加或不加假体、硅凝胶乳房假体、保留乳头乳晕复合体的方法对其中74例施行乳腺癌改良根治术的患者进行乳房整形手术,总结该74例患者的临床病例资料,对术后美容效果及远期预后进行评估。结果:患者均为女性,年龄分布35～68岁,平均(48.2±6.5)岁,中位年龄46岁。12例患者仅采用改良根治术治疗,74例应用乳房整形技术的患者中,采用腹直肌肌皮瓣(TRAM)进行乳房再造26例,腹壁下动脉穿支皮瓣(DIEP)乳房再造术6例,TRAM与DIEP联合皮瓣行乳房再造术8例,背阔肌肌皮瓣(LDF)加或不加假体进行乳房再造20例,硅凝胶乳房假体进行乳房再造8例,保留乳头乳晕复合体进行乳房再造6例。不同整形技术对乳腺癌术后的恢复及并发症的发生率有影响,差异存在统计学意义,采用整形技术及单纯根治术治疗,乳腺癌术后恢复及并发症发生率的差异未发现统计学意义。术后随访10～16个月,未发现局部和区域肿瘤复发,无伤口、皮肤坏死和感染,未发现死亡病例,继续随访观察。结论:I、II期乳腺癌患者在行改良根治术后,应用乳房整形技术治疗是安全、有效的,腹直肌肌皮瓣乳房再造术进行乳房美容的效果最好,乳房整形术术后并发症较传统单纯乳腺癌改良根治术发生率无明显变化,具有广阔的应用前景。Objective Evaluate the effects and prognosis of plastic surgery on breast cancer. Methods From March 2007 to February 2011, clinical information of 86 patients with early stage breast cancer were collected and reviewed retrospectively.Among them,74patients were given postoperative pJastic surgery, we adopted six methods in treatment, the effects and prognosis were assessed in the end. Results All of 74 patients who received plastic surgery were in stage I-II before surgery. Breast reconstruction with transverse rectus abdominis myocutaneous （TRAM） flap was conducted in 26 cases,DIEP was used in 6 cases,TRAM associated with DIEP was conducted in 8cases,latissimus- dorsi musculocutaneous flap （LDF） with or without breast rebuilding was conducted in20 cases,reconstruction with Silicone gel breast prosthesis was used in 8cases,and 6 cases of them received nipple-conserving reconstruction. Statistical differences were found in results of these four methods. Satisfactory effects were achieved in all cases. Conclusions It is security and reliable for patients with stage Ⅰ、Ⅱ breast cancer to have modified radical mastectomy combined with immediate breast reconstruction.The surgery conducted by LDF flap worked best,while the prosthesis implantation is simptest one to perform.Postoperative complications were the same as normal modified radical mastectomy; these methods have wide application prospects.

关 键 词：乳腺癌 改良根治术 保乳手术 乳房整形技术 

分 类 号：R655.8[医药卫生—外科学]